title: Ostomy-related complications after emergent abdominal surgery: a 2-year follow-up study.
abstract: OBJECTIVE
  The aim of this study was to prospectively evaluate ostomy-related complications and describe ostomy configuration in patients undergoing acute abdominal surgery.
  
  
  METHODS
  The study sample comprised 144 patients with a median age of 67 years (IOR: 53.5-78 years) who underwent an intestinal ostomy as part of an acute abdominal surgical procedure. The research setting was the surgical and gynecological clinics at the Sahlgrenska University Hospital in Gothenburg, Sweden.
  
  
  METHODS
  Ostomy configuration, diameter, height, and the presence of stomal and peristomal complications were assessed by a WOC nurse 1 to 2 times while in hospital, once at the ostomy outpatient clinic 2 weeks after discharge, and at 3, 6, 12, and 24 months following ostomy creation.
  
  
  RESULTS
  The types of ostomies evaluated were end colostomy (58%), end ileostomy (18%), loop ileostomy (17%), and loop colostomy (7%). Most stomal or peristomal complications occurred within 1 year after surgery (31 of 57; 54.4%). Necrosis, separation, and stenosis were most common in patients with an end colostomy. Peristomal skin complications occurred in 45% of subjects during the first 6 months after surgery. The ostomy's diameter decreased significantly during the hospital course and over the first 2 weeks following hospital discharge in patients with end colostomy (P< .0001), end ileostomy (P< .0081), loop ileostomy (P= .008), and loop colostomy (ns). Patients with a low ostomy had peristomal skin problems ranging between 21% and 57% over this time period. The frequency of using a pouching system that incorporated convexity was highest in the case of loop ileostomy, used in 67% at 6 months.
  
  
  CONCLUSIONS
  During the first 2 weeks after discharge, the physical configuration of the ostomy evolves and the pouching system must be frequently adjusted by a WOC nurse. Stomal and peristomal complications are prevalent during the first 2 postoperative years and especially during the first 6 months.
authors.affiliation: Elisabet Lindholm, RN, ML, Colorectal Unit, Sahlgrenska University Hospital, Gothenburg, Sweden. Eva Persson, PhD, RN, WOC, School of Health Sciences, University of Borås, Borås, Sweden. Eva Carlsson, PhD, RN, WOC, Institute for Care and Health Sciences, Sahlgrenska Academy, University of Gothenburg and Colorectal Unit, Sahlgrenska University Hospital, Gothenburg, Sweden. Anne-Marie Hallén, RN, WOC, MA, Colorectal Unit, Sahlgrenska University Hospital, Gothenburg, Sweden. Jeanette Fingren, RN, WOC, Colorectal Unit, Sahlgrenska University Hospital, Gothenburg, Sweden. Ina Berndtsson, RN, WOC, Associate Professor, Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Lindholm
authors.forename: Eva
authors.initials: E
authors.lastname: Persson
authors.forename: Eva
authors.initials: E
authors.lastname: Carlsson
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hallén
authors.forename: Jeanette
authors.initials: J
authors.lastname: Fingren
authors.forename: Ina
authors.initials: I
authors.lastname: Berndtsson
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D003125:Colostomy; D004630:Emergencies; D005260:Female; D006801:Humans; D007081:Ileostomy; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies